Body dysmorphic disorder

Let’s face it – at one time or another you’ve wished a part of your body looked a little different. It might be that you think your thighs are too big, your skin’s not perfect, or your nose has that little bump in the middle that EVERYONE can notice. This kind of thinking is pretty common and normal, whether it’s true or not. However, it becomes a problem is when it starts to rule your life.

You can become totally preoccupied with the part of your body that you think is not okay, and these beliefs severely interfere with the quality of your life. This kind of obsessing over a part of your body is known as body dysmorphic disorder (or BDD).

How BDD might affect you

There are many different types of behaviours and symptoms that you might experience if you have BDD, however you don’t have to experience all of them. Some common ones are:

  • frequently checking out how you look in mirrors
  • picking at your skin
  • constantly making sure you look clean and well groomed
  • frequently touching the part of your body that you don’t like
  • trying to hide or disguise the body part or yourself
  • avoiding going out or being with others because you feel so self-conscious about an aspect of your appearance
  • feeling depressed or anxious
  • trying to ‘fix’ the body part – through exercise, medication, surgery, and other sorts of treatment.
  • feeling suicidal (if you’re worried about this and need information about how to keep yourself safe, please read wanting to end your life or go to get help now to get some support straight away)

If you’re concerned that these behaviours sound familiar it is important that you speak to a doctor or psychologist to find out more.

Why it happens

BDD doesn’t have a single cause. It is often due to a variety of different physical and mental health issues. These are just some of that factors that may contribute to having BDD:

  • having low self-esteem and negative beliefs about yourself
  • experiencing negative thoughts – ‘Everybody hates me because I am ugly,’ or ‘I will never be anything unless I look okay’
  • cultural emphasis and fixation on the ideal body
  • feeling a lack of control in your life
  • stress or coping styles
  • feeling as though you cannot manage difficult emotions/feelings any other way
  • relationships with family and peers
  • genetics and chemistry
  • sexual abuse or trauma

Getting help

If you are concerned that you might have BDD, it is important that you see a GP or psychologist to talk about it and find out more about which options might be best for you. Getting the right assistance can help you enjoy your life again. Some of your options may include:

  • Cognitive Behavioural Therapy (CBT) from a psychologist can be really helpful when dealing with BDD as it can give you a feeling of power and control over your thoughts, enabling you to learn ways of overcoming the tendency to think negatively.
  • There is also a treatment known as response prevention. This is when you learn how to develop other ways of coping with the urges to do the behaviours you might do as a result of your BDD.
  • Medication from your GP can sometimes also be useful in reducing the intensity of your negative thoughts.
  • BDD can sometimes exist with other psychological problems such as Depression, Obsessive Compulsive Disorder (OCD) and social phobia. Therapy for these problems may also help your BDD.

Other things that might be helpful:

  • Take a look inside an art gallery or in books at the library – what do the people look like in these pictures? What makes them beautiful? What makes you want to look at them?
  • Join a support group – it may be helpful to share your experiences with people who are going through similar situations
  • Write some of your feelings down in a journal
  • Write down some positive affirmations and put them around the house or carry them with you eg – ‘I am okay’, ‘I am worthwhile’
  • Write a list about the things that are okay about yourself – it can be anything from being a good friend to liking your big toe!
  • Write a list of the things you like about your friend – how important to you is the way they look or are there other things about them that you really like?  What do they like about you?
  • Take the time to do nice things for your body – like going for a massage, having a bath with nice smelling salts, getting your nails done
  • Make a list of things you can do to distract yourself from your behaviours. This can be stuff like going for a walk with the dog, listening to some positive music, watching your favourite movie. Then put each thing in a box/container and when you feel upset pick one out and do it. Keep doing it until you feel okay again. If you finish your entire list – start again!

More support

Check out Bodywhys for more information and support around BDD.

Acknowledgements

Edited by Headstrong

Helpful sites

Comments Show all comments

  1. ReachOut.com says:

    Hi John,

    We asked our friends in Bodywhys to reply to your comment, as they have more knowledge in this area than we do. Please see Harriet's reply to your comment below.

    Dear John,

    Thanks for your comment and I can hear just how difficult you are finding things. It is incredibly difficult to have these feelings for oneself, and also to acknowledge them to oneself and to others. To try and bring yourself some relief, it is important to try and think about when these feelings started, and what was happening for you when they did. Oftentimes, when a person feels that they hate their body, it is a response of sorts to something else in their life that feels maybe beyond one’s control, or difficult to cope with. Then it can often be that a person turns inwards to themselves, and their physical body as a focus for the negative thoughts. I say this because you have written also that there is a disparity to what you experience, there is a kind of divide between what you feel people see and how you feel about yourself.

    It can be very stressful and distressing to feel that one is going through life hating oneself under one’s clothes, this feeling of a hidden hating. This can affect a person’s ability to live and work as they wish, and to experience a range of emotions including joy and contentment, which although fleeting for everyone, are an important part of feeling oneself to be living.

    I wonder would you consider talking to somebody one to one about these strong feelings you have? I wonder whether trying to tease out what they are, when they feel powerful, when they recede, when they kick in, would help you to find some peace and understanding so that you can try to give yourself the chance to let go of this feeling of hating your body. If this is something you would like to try then there are many different avenues to try. You can speak with your local doctor/GP about how you are feeling and they can recommend a specialist for you to speak with, or you can look up www.counsellingdirectory.ie for details of counsellors and therapists working across Ireland. It is important to try a couple of people, to find someone that you feel understand you, that you could try talking to.

    If you feel that this step is a bit too hard right now, then it might be worth looking at the OCD Ireland website. They have lots of useful information and also run support groups for issues such as you have, which you may find helpful to start you thinking about what you can do to help yourself with these feelings you are having. For more information on these support groups, you can phone St.Patrick's Hospital on 01 249 3333 or email them on info@stpatsmail.com.

    You're not on your own with this John, and I hope something in this email is a start for you.
    Harriet - Bodywhys

  2. John says:

    Im 68 and have hated my body for as long as I remember . Im told im attractive but under my clothes I hate myself

  3. ReachOut.com says:

    Thanks for leaving a comment Bob - we appreciate it and we know that it will encourage others reading it too. You seem really self-aware and it's good that you feel better equipped and empowered to take the next steps in sorting out your issues,
    Take care
    Derek

  4. Bob says:

    Just read this article as i am really struggling at the mo wasnt sure what was going on in my life but stumbled across this and feel a little bit more aware of whats wrong with me. Cant really talk to anyone friends family girlfriend cause im afraid of what they will think of me especially my girlfriend she might think im weak or stupid cause even though my problem might seem silly to others its really sending me into ground. Definately going to take this further to try sort my issues out. The problem i have never really bother me when i was younger although i always knew it was there but now im a bit older its really effecting me now in social and employment and worried cause i was hoping that the fact im getting older i thought i would care less about the issue but no its actually as bad as ever. Doing some crazy things to try and disguise my issue exactly as the article says im so happy ive seen this cause i really thought i was about to explode great article it summed me up exactly so much that it was like it was about me. You know your stuff and thanks from the botton of my heart at least now i wont feel to weird having the courage speaking to a doc or pys.. head doctor ha. The reason im leaving a comment is so that it might make someone else out there feel a bit better or least know they are not alone. Will try exactly what what is advised and will check back in soon. Thanks again although im not sorted just yet its a definate step in the right direction cause the way i fell of late is shocking and weird is best way of putting it. It kills me to feel like this cause im normally so happy and bubbly but i now know this is just a front and cant fix this myself so i need help. Thanks and gob bless

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